Provider Demographics
NPI:1518306638
Name:MORANT, RICARDO DAVID (DMD)
Entity Type:Individual
Prefix:DR
First Name:RICARDO
Middle Name:DAVID
Last Name:MORANT
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1358 BOSTON POST RD
Mailing Address - Street 2:
Mailing Address - City:OLD SAYBROOK
Mailing Address - State:CT
Mailing Address - Zip Code:06475-1751
Mailing Address - Country:US
Mailing Address - Phone:860-388-3522
Mailing Address - Fax:860-388-3526
Practice Address - Street 1:1358 BOSTON POST RD
Practice Address - Street 2:
Practice Address - City:OLD SAYBROOK
Practice Address - State:CT
Practice Address - Zip Code:06475-1751
Practice Address - Country:US
Practice Address - Phone:860-388-3522
Practice Address - Fax:860-388-3526
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-21
Last Update Date:2013-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0089241223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics